UK hospitals are set to be graded under a new “Ofsted-style” ranking system, based on frequent inspections of every department, in the latest shake-up to the NHS.
The system, which resembles that currently used by education regulator Ofsted to grade schools, will award hospitals a single simple grade of either “inadequate”, “requires improvement”, “good” or “outstanding”, the Care Quality Commission (CQC) unveiled this week.
The CQC, which is responsible for regulating care in the NHS, hopes the ratings will drive up standards, giving patients and families a better insight into the quality of treatment they can expect from particular hospital services.
“It’s going to be tougher and much more rigorous, and will be much more clear about when services are failing or inadequate,” said David Behan, the CQC’s chief executive.
The changes are set to begin in October, with the first findings published in December. CQC inspectors will rate every hospital department, as well as every hospital and hospital trust under the new system, based on examinations of whether the care being provided is safe, effective, caring and compassionate, well-led and responsive to patients’ needs.
If an inspector reports problems, the chief inspector of hospitals Sir Mike Richards will issue a warning notice. The hospital will be given a fixed period – perhaps only a few days – to amend the situation.
Inspectors will also look to see if hospitals have failed to deliver any of the ten new “fundamental standards” of care, as suggested by the Francis Report.
Published in February, the report outlined the findings of Robert Francis QC’s public inquiry into the Stafford Hospital scandal. Between 2005 and 2008, up to 1,200 people were said to have died unnecessarily at the NHS hospital due to “appalling standards of care.”
The report led Health Secretary Jeremy Hunt to order the institution of the new regulatory system shortly after its publication. Under the previous, much criticised system, the CQC only reported whether or not hospitals met the minimum standards of care. Critics had labelled it a “tick-box exercise” that failed to encourage improvement.
“As an MP I know how well each school in my constituency is doing thanks to independent and thorough Ofsted inspections,” said Hunt when the new proposals were made late last year. “But because the CQC only measures whether minimum standards have been reached, I do not know the same about hospitals and care homes.”
Hunt has now approved the CQC’s new plans, saying that it reflected a major programme of changes in the NHS that meant “setting clear standards of care and publishing ratings so that patients have a single version of the truth about how their hospitals are performing on finance, leadership and, most importantly, the quality of care.”
The Academy of Medical Royal Colleges, which represents the UK’s 220,000 doctors, has also a welcomed the new scheme.
But Mike Farrar, chief executive of the NHS Confederation, has been more critical, stating that the CQC is still yet to persuade NHS managers to accept the changes. In a recent poll, almost three quarters of NHS chief executives and chairs said they disagreed with the implementation of Ofsted-style ratings.
Farrar suggests such as system risks “skewing resources to only those areas being measured.”
“We welcome steps to improve transparency within the NHS,” he said. “But in doing so, we must avoid creating perverse incentives whereby a single focus develops on those areas being measured alone, at the expense of other areas that are equally as important.”
